Complaint Thursdays

[spndnchz]

Having to take the blame when it's entirely NOT your fault. You cannot buy your own piece of mind at the expense of others.

[dEnnis the Menace]

medical insurance.  While I am grateful for it, as it saved my wife an me over a quarter of a million dollars with our twins stay in the NICU, the things they are fighting us on is ridiculous.  

 

24 hours after our twins were born, they had to be transported to a higher level NICU in Syracuse (Crouse).  The insurance tried telling us that their transportation was not an emergency and therefore they would not cover it.  I spent 2 and a half hours on the phone with the insurance explaining to them why it actually was an emergency.  I then asked who denied the initial claim, and apparently, it never made it out of their claims department for a medical professional to review.  Got that one reversed.

 

Then we're told that our one son needs a helmet to correct his plagio-and brachio-cephaly (flattening of the back and widening of the side of his head).  It was mostly caused by his stay in the NICU. The doctors placed him in the incubator thing the same way everyday, and the machines were always to one side, so he only ever looked to his right, so his left side of his head is flat.  No problem.  It's fixable with a helmet, as long as you put it on around 4-6 months, and can leave it on for 4 - 6 months.  The longer you wait, the less fixing the helmet can do.  

 

Well insurance didn't feel they need to cover it (it costs $4k out of pocket).  I had 4 (FOUR) medical professionals write a letter to the insurance company, with all of the objective evidence required by CIGNA, and I was told that the proper procedure was not followed and I needed an appeal.  Filed the appeal, with a request to expedite because my kids are now 6 months old (this started when they were 4 months old).  Request to expedite denied, they will mail me a letter on Nov. 13, which I won't receive for 3 - 5 business days, and that letter will have their decision in it.  If I disagree with that, I can request a peer-peer review.  My sons orthotist calls the insurance...and they haven't even had a medical professional review the case file.  WTF?!

 

So we paid out of pocket (My wife's grandparents loaned us the money).  Luckily, the Hanger clinic doesnt charge full price to patients whose insurance are heads.  So it was a little less than half.  But still. I am so fed up with calling the insurance company, getting a different person everytime, along with a different story.  Bunch of pricks.   

[darksabre]

medical insurance.  While I am grateful for it, as it saved my wife an me over a quarter of a million dollars with our twins stay in the NICU, the things they are fighting us on is ridiculous.  

 

24 hours after our twins were born, they had to be transported to a higher level NICU in Syracuse (Crouse).  The insurance tried telling us that their transportation was not an emergency and therefore they would not cover it.  I spent 2 and a half hours on the phone with the insurance explaining to them why it actually was an emergency.  I then asked who denied the initial claim, and apparently, it never made it out of their claims department for a medical professional to review.  Got that one reversed.

 

Then we're told that our one son needs a helmet to correct his plagio-and brachio-cephaly (flattening of the back and widening of the side of his head).  It was mostly caused by his stay in the NICU. The doctors placed him in the incubator thing the same way everyday, and the machines were always to one side, so he only ever looked to his right, so his left side of his head is flat.  No problem.  It's fixable with a helmet, as long as you put it on around 4-6 months, and can leave it on for 4 - 6 months.  The longer you wait, the less fixing the helmet can do.  

 

Well insurance didn't feel they need to cover it (it costs $4k out of pocket).  I had 4 (FOUR) medical professionals write a letter to the insurance company, with all of the objective evidence required by CIGNA, and I was told that the proper procedure was not followed and I needed an appeal.  Filed the appeal, with a request to expedite because my kids are now 6 months old (this started when they were 4 months old).  Request to expedite denied, they will mail me a letter on Nov. 13, which I won't receive for 3 - 5 business days, and that letter will have their decision in it.  If I disagree with that, I can request a peer-peer review.  My sons orthotist calls the insurance...and they haven't even had a medical professional review the case file.  WTF?!

 

So we paid out of pocket (My wife's grandparents loaned us the money).  Luckily, the Hanger clinic doesnt charge full price to patients whose insurance are ###### heads.  So it was a little less than half.  But still. I am so fed up with calling the insurance company, getting a different person everytime, along with a different story.  Bunch of ###### pricks.   

You got that right. 

[Randall Flagg]

THREE politics threads at the top of sabrespace.

 

:P

[darksabre]

THREE politics threads at the top of sabrespace.

 

:P

Welcome to Thunderdome

[josie]

I'm sorry Dennis. That whole system is borked. 

 

Another person fired from the company.... I'm beginning to fear that my safety net of working remote when I move to Buff in the Spring may not be there... I could be facing unemployment and no income for some time until I swallow my pride, forget all my hard work and just become another loser artist flipping burgers. My fault for not going into a STEM program like everyone told me to. 

 

Then again, apparently there's enough money to take the drinking buddies to NYC on the company's dime... at least that's the pretty well founded rumour. I just get mad at everything nowadays. 

[LGR4GM]

medical insurance.  While I am grateful for it, as it saved my wife an me over a quarter of a million dollars with our twins stay in the NICU, the things they are fighting us on is ridiculous.  

 

24 hours after our twins were born, they had to be transported to a higher level NICU in Syracuse (Crouse).  The insurance tried telling us that their transportation was not an emergency and therefore they would not cover it.  I spent 2 and a half hours on the phone with the insurance explaining to them why it actually was an emergency.  I then asked who denied the initial claim, and apparently, it never made it out of their claims department for a medical professional to review.  Got that one reversed.

 

Then we're told that our one son needs a helmet to correct his plagio-and brachio-cephaly (flattening of the back and widening of the side of his head).  It was mostly caused by his stay in the NICU. The doctors placed him in the incubator thing the same way everyday, and the machines were always to one side, so he only ever looked to his right, so his left side of his head is flat.  No problem.  It's fixable with a helmet, as long as you put it on around 4-6 months, and can leave it on for 4 - 6 months.  The longer you wait, the less fixing the helmet can do.  

 

Well insurance didn't feel they need to cover it (it costs $4k out of pocket).  I had 4 (FOUR) medical professionals write a letter to the insurance company, with all of the objective evidence required by CIGNA, and I was told that the proper procedure was not followed and I needed an appeal.  Filed the appeal, with a request to expedite because my kids are now 6 months old (this started when they were 4 months old).  Request to expedite denied, they will mail me a letter on Nov. 13, which I won't receive for 3 - 5 business days, and that letter will have their decision in it.  If I disagree with that, I can request a peer-peer review.  My sons orthotist calls the insurance...and they haven't even had a medical professional review the case file.  WTF?!

 

So we paid out of pocket (My wife's grandparents loaned us the money).  Luckily, the Hanger clinic doesnt charge full price to patients whose insurance are ###### heads.  So it was a little less than half.  But still. I am so fed up with calling the insurance company, getting a different person everytime, along with a different story.  Bunch of ###### pricks.   

And this is why we need additional healthcare reform. 

[Randall Flagg]

One of my close high school friends has been in the hospital battling infections and other nasty stuff. I got a phone call last Sunday, and was informed that she had passed away. I brought the message to two of our friends from home who go to school with me, and we had an incredibly rough day. Then we found out that somehow, the wrong information had come out. She's still with us and battling, and apparently is now turning a corner after having an organ removed to try and stem the infection. We're incredibly happy about this and are allowing ourselves to feel hope for the first time (the doctors had none of it five days ago)

 

I'm still messed up over the fact that I was told, and told other people, the incorrect information. Their reactions won't get out of my head.

[WildCard]

That's rough Flagg, glad to hear your friend has gotten better though. I hope everything works out for you

 

Not trying to 1-up you, but I watched my buddy die and had to deliver that news to my brother. It'sa terrible thing to have to do

Edited October 6, 2016 by WildCard

[biodork]

medical insurance.  While I am grateful for it, as it saved my wife an me over a quarter of a million dollars with our twins stay in the NICU, the things they are fighting us on is ridiculous.  

 

24 hours after our twins were born, they had to be transported to a higher level NICU in Syracuse (Crouse).  The insurance tried telling us that their transportation was not an emergency and therefore they would not cover it.  I spent 2 and a half hours on the phone with the insurance explaining to them why it actually was an emergency.  I then asked who denied the initial claim, and apparently, it never made it out of their claims department for a medical professional to review.  Got that one reversed.

 

Then we're told that our one son needs a helmet to correct his plagio-and brachio-cephaly (flattening of the back and widening of the side of his head).  It was mostly caused by his stay in the NICU. The doctors placed him in the incubator thing the same way everyday, and the machines were always to one side, so he only ever looked to his right, so his left side of his head is flat.  No problem.  It's fixable with a helmet, as long as you put it on around 4-6 months, and can leave it on for 4 - 6 months.  The longer you wait, the less fixing the helmet can do.  

 

Well insurance didn't feel they need to cover it (it costs $4k out of pocket).  I had 4 (FOUR) medical professionals write a letter to the insurance company, with all of the objective evidence required by CIGNA, and I was told that the proper procedure was not followed and I needed an appeal.  Filed the appeal, with a request to expedite because my kids are now 6 months old (this started when they were 4 months old).  Request to expedite denied, they will mail me a letter on Nov. 13, which I won't receive for 3 - 5 business days, and that letter will have their decision in it.  If I disagree with that, I can request a peer-peer review.  My sons orthotist calls the insurance...and they haven't even had a medical professional review the case file.  WTF?!

 

So we paid out of pocket (My wife's grandparents loaned us the money).  Luckily, the Hanger clinic doesnt charge full price to patients whose insurance are ###### heads.  So it was a little less than half.  But still. I am so fed up with calling the insurance company, getting a different person everytime, along with a different story.  Bunch of ###### pricks.   

I hear you, dEnnis.  My dad and stepmom thought they'd won their appeal for continuing her Medicaid coverage last month, but hadn't gotten the official letter yet.  They found out on Monday when they tried to refill one of her prescriptions that her coverage had been terminated.  No advance notice, no explanation.  Apparently the DSS is trying to pick and choose when they apply eligibility rules for a household of 1 and when they apply them for a household of 2 in order to void her eligibility.  They're trying to fight it again, but right now she's a diabetic with high blood pressure, high cholesterol, and depression who is uninsured and unemployed.  F*ck the system.

 

One of my close high school friends has been in the hospital battling infections and other nasty stuff. I got a phone call last Sunday, and was informed that she had passed away. I brought the message to two of our friends from home who go to school with me, and we had an incredibly rough day. Then we found out that somehow, the wrong information had come out. She's still with us and battling, and apparently is now turning a corner after having an organ removed to try and stem the infection. We're incredibly happy about this and are allowing ourselves to feel hope for the first time (the doctors had none of it five days ago)

 

I'm still messed up over the fact that I was told, and told other people, the incorrect information. Their reactions won't get out of my head.

That is seriously messed up.  Hopefully she continues to improve!

 

That's rough Flagg, glad to hear your friend has gotten better though. I hope everything works out for you

 

Not trying to 1-up you, but I watched my buddy die and had to deliver that news to my brother. It'sa terrible thing to have to do

:(

[bob_sauve28]

I ate a breakfast of cereal and for lunch I just had a salad and some veggies. I am SO hungry now I might tear off someone's arm and eat it. What was I thinking???

[shrader]

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

[darksabre]

My dad moved into an assisted care home at the start of september. Two nights ago they found him passed out on the floor. When they woke him up, the side of his face was droopy, so they thought he may have had a stroke. Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke. In the process though, they found a mass in his brain. He's scheduled for surgery on monday.

:(

[wjag]

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

 

Hoping for the best possible outcome.

[PASabreFan]

This was a tough thread to catch up on. My sorries to all who've been going through some terrible stuff.

[nfreeman]

Sorry Shrader.  God bless your dad and your family.

[josie]

Just had confirmation- my safety net is gone. I don't know what I'm going to do in the spring. 

 

 

I know it pales in comparison to the other things in here. Sorry. 

[dEnnis the Menace]

I hear you, dEnnis.  My dad and stepmom thought they'd won their appeal for continuing her Medicaid coverage last month, but hadn't gotten the official letter yet.  They found out on Monday when they tried to refill one of her prescriptions that her coverage had been terminated.  No advance notice, no explanation.  Apparently the DSS is trying to pick and choose when they apply eligibility rules for a household of 1 and when they apply them for a household of 2 in order to void her eligibility.  They're trying to fight it again, but right now she's a diabetic with high blood pressure, high cholesterol, and depression who is uninsured and unemployed.  F*ck the system.

 

That is seriously messed up.  Hopefully she continues to improve!

 

:(

 

That is just crazy bio! Bes tof luck to your parents.  It's so difficult dealing with the insurance.

 

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

 

Sorry to hear Shrader. Praying for the best. 

 

Just had confirmation- my safety net is gone. I don't know what I'm going to do in the spring. 

 

 

I know it pales in comparison to the other things in here. Sorry. 

 

:(

[biodork]

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

:( Prayers for your dad to have a successful operation.

 

Just had confirmation- my safety net is gone. I don't know what I'm going to do in the spring. 

 

 

I know it pales in comparison to the other things in here. Sorry. 

:(

[bob_sauve28]

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

Hope that goes well. I have an elderly parent that is going down hill and nothing in life can prepare us for this

[Ogre]

Shrader, I definitely have you and your family in my prayers.

[biodork]

Shrader, I definitely have you and your family in my prayers.

How's your mom doing, iTlnSn?

[Taro T]

You all know of my hesitation to be a complainer and there's a good reason for it but here I go. Two weeks ago my mother was taken to the hospital with severe abdominal pain. She hadn't seen a doctor since her last child was born 42 yrs ago. They were having a tough time figuring out her problem and she had been suffering the whole time. Last Friday they took my father into the hospital with a blood infection. He's been on the feeble side for years and we were of course all worried. By Sunday night they had realized that my mother's colon was severely inflamed and needed to come out that night. Meanwhile they moved Dad out of ICU because he seemed to be getting better. I got to the hospital early Monday morning from WNY to learn that Dad had passed away. My mother was now in ICU under sedation from her surgery the night before. They didn't remove the ventilator from her until Tuesday morning but the doctor told us it was unwise to tell her about Dad until Wednesday so we were given a brief visit thinking she would be groggy and forget to ask how Dad was doing. Of course all she wanted was to hear how he was so we lied to her. Yesterday we broke the news to her. Not a very fun day at all. The part where us boys needed to make a decision on embalming or cremation ran us ragged because with Mom unavailable we had a very vague idea as to what he actually wanted. Luckily we're all tough as nails and made the right choice. We have been handling all the nuts and bolts type stuff that need to be done and focusing on her. I haven't even had time to grieve for my father yet. Maybe this post is me beginning the process. My Dad was tough as nails and never wanted any of us to be whiners. "The world has enough of those" he would say. Fred was a very good man and I am fortunate to have his genes and his philosophy on life. Fred was only 70 yrs old. God Bless you, man. You were the best.

Just saw this now. You have my sincerest condolences. I hope your mother has a speedy and (as) full (as possible) recovery. I can't imagine going through that week. :(

[Ogre]

How's your mom doing, iTlnSn?

She was released from the hospital yesterday and avoided the rehab facility by will alone. They did find cancer so in few weeks she needs to start treatment. She has started to plan Dad's service so we can finally lay him to rest. She's a relentlessly tough woman. She deals with this crap like a pro. Thanks for asking, bio.

[Taro T]

My dad moved into an assisted care home at the start of september.  Two nights ago they found him passed out on the floor.  When they woke him up, the side of his face was droopy, so they thought he may have had a stroke.  Yesterday, at the hospital, they determined that it was bell's palsy and not a stroke.  In the process though, they found a mass in his brain.  He's scheduled for surgery on monday.

Prayers going out for you and your dad.